Category Archives: Spinal Cord Injury

Traumatic Brain Injury – TBI and Spinal Cord Injury SCI

The VA says this about TBI and SCI: 

Due to the ongoing conflicts in Afghanistan and Iraq, Traumatic Brain Injury (TBI) and Spinal Cord Injury (SCI) accounts for almost 25% of combat casualties.

Improvised explosive devices, blast (high pressure waves), landmines, and explosive fragments account for the majority of combat injuries in Afghanistan and Iraq. Although Kevlar helmets and advances in body armor have saved the lives of many soldiers, they do not protect against blasts and impacts to the head, face and cervical spinal cord.

Blast injuries often result in multiple traumas, including injuries to internal organs, limb loss, sensory loss, and psychological disorders. The term “polytrauma” has been coined to describe the co-occurring injuries.

The information above and below come from here which are part of an introduction and overview prepared by Joel Kupersmith, MD, Chief Research and Development Officer, VA for the purposes of a proposal solicitation.  I thought the overview might be of interest to those with these injuries and their families.

Traumatic Brain Injury:

Kevlar helmets have done much to protect the head but leave the forehead unprotected. The left and right frontal lobes, located behind the forehead control intellectual abilities such as the ability to plan and organize. This area of the brain also controls personality, behavior, and emotional control.

Concussion or mild TBI is the most common form of combat-related injury. Mild TBI can occur even in those not directly hit by the blast, without obvious external injuries, without loss of consciousness and without visible findings from acute Magnetic Resonance Imaging. Problems with memory, lack of concentration, increased anxiety and irritability are common hallmarks of mild TBI. Although evidence suggests that the majority of OIF/OEF soldiers who suffer mild TBI will recover over time, early diagnoses and treatment are critical so that aberrant behaviors due to TBI are not misinterpreted and soldiers are spared the risk of second impact syndrome. Appropriate recognition of TBI will facilitate quick return to pre-injury activity levels, including return to duty status.

In addition to mild TBI, soldiers close to the blasts are experiencing severe diffuse and contrecoup injuries. Soldiers with a moderate to severe TBI often show the similar symptoms as mild TBI yet also report: worsening headaches; repeated vomiting or nausea; seizures; inability to awaken from sleep; slurred speech; weakness, numbness and loss of coordination. Unlike mild TBI, these problems and others can persist long-term or result in permanent difficulties with memory, reasoning, emotion and expression making it impossible to return to duty, hold steady employment or regain pre-injury quality of life.

Penetrating focal injuries from mortar rounds or other forms of heavy artillery resulting in severe brain injury are not as prevalent. However, focal destruction of brain tissue is the most life-threatening, intractable type of brain injury causing permanent damage to the affected area and the functions it controls.

Spinal Cord Injury:

Current designs in military protective gear and advanced evacuation procedures have resulted in both a decrease in the percentage of spinal cord injured soldiers and an increase in the number of those that ultimately survive. Blast force and shrapnel injuries are most common. For those that survive, the cervical spinal cord, the unprotected and most mobile portion of the spinal cord, is the most common site of injury.

Soldiers with cervical SCI face short- and long-term consequences of losing motor and sensory function below the level of injury, coupled with a loss of autonomic regulation. Every organ system may be affected by cervical spinal cord injury. Alterations in the gastrointestinal, renal, skin and musculoskeletal organs are common, and respiratory problems are the overwhelming cause of morbidity and mortality. In addition, patients may experience chronic pain at or below the level of injury and, less frequently, above it.

Alterations in respiratory mechanics, and the development of alveolar hypoventilation, pneumonia, aspiration of gastric contents, pulmonary embolism, pulmonary edema, and sleep apnea are a few of the common respiratory complications associated with cervical SCI. Ultimately, dysfunction depends on the level and extent of injury. Lesions above C3 paralyze all respiratory muscles. When SCI involves C3 to C5 lesions, profound respiratory muscle dysfunction occurs leaving the patient unable to generate a cough or clear secretions. Because of this, neuroprotective strategies that rescue even one or two segments may be of significant functional benefit to veterans with SCI.

Let’s pray that this proposal results in research that leads to significant help for our injured veterans.    

Oldtimer